Jasmir G Nayak1, Nicholas Scalzo2, Alice Chu2, Benjamin Shiff1, James T Kearns2, Geolani W Dy3, Liam C Macleod4, Matthew Mossanen5, William J Ellis2, Daniel W Lin2, Jonathan L Wright2, Lawrence D True6, John L Gore7. 1. Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada. 2. Department of Urology, University of Washington, Seattle, WA, USA. 3. Department of Urology, New York University, New York, NY, USA. 4. Department of Urology, University of Pittsburgh Medical Center, Hermitage, PA, USA. 5. Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 6. Department of Pathology, University of Washington, Seattle, WA, USA. 7. Department of Urology, University of Washington, Seattle, WA, USA. jnayak@sbgh.mb.ca.
Abstract
PURPOSE: The prostate biopsy pathology report represents a critical document used for decision-making in patients diagnosed with prostate cancer, yet the content exceeds the health literacy of most patients. We sought to create and compare the effectiveness of a patient-centered prostate biopsy report compared with standard reports. MATERIALS AND METHODS: Using a modified Delphi approach, prostate cancer experts identified critical components of a prostate biopsy report. Patient focus groups provided input for syntax and formatting of patient-centered pathology reports. Ninety-four patients with recent prostate biopsies were block randomized to the standard report with or without the patient-centered report. We evaluated patient activation, self-efficacy, provider communication skills, and prostate cancer knowledge. RESULTS: Experts selected primary and secondary Gleason score and the number of positive scores as the most important elements of the report. Patients prioritized a narrative design, non-threatening language and information on risk classification. Initial assessments were completed by 87% (40/46) in the standard report group and 81% (39/48) in the patient-centered report group. There were no differences in patient activation, self-efficacy, or provider communication skills between groups. Patients who received the patient-centered report had significantly improved ability to recall their Gleason score (100% vs. 85%, p = 0.026) and number of positive cores (90% vs. 65%, p = 0.014). In total, 86% of patients who received the patient-centered report felt that it helped them better understand their results and should always be provided. CONCLUSIONS: Patient-centered pathology reports are associated with significantly higher knowledge about a prostate cancer diagnosis. These important health information documents may improve patient-provider communication and help facilitate shared decision-making among patients diagnosed with prostate cancer.
RCT Entities:
PURPOSE: The prostate biopsy pathology report represents a critical document used for decision-making in patients diagnosed with prostate cancer, yet the content exceeds the health literacy of most patients. We sought to create and compare the effectiveness of a patient-centered prostate biopsy report compared with standard reports. MATERIALS AND METHODS: Using a modified Delphi approach, prostate cancer experts identified critical components of a prostate biopsy report. Patient focus groups provided input for syntax and formatting of patient-centered pathology reports. Ninety-four patients with recent prostate biopsies were block randomized to the standard report with or without the patient-centered report. We evaluated patient activation, self-efficacy, provider communication skills, and prostate cancer knowledge. RESULTS: Experts selected primary and secondary Gleason score and the number of positive scores as the most important elements of the report. Patients prioritized a narrative design, non-threatening language and information on risk classification. Initial assessments were completed by 87% (40/46) in the standard report group and 81% (39/48) in the patient-centered report group. There were no differences in patient activation, self-efficacy, or provider communication skills between groups. Patients who received the patient-centered report had significantly improved ability to recall their Gleason score (100% vs. 85%, p = 0.026) and number of positive cores (90% vs. 65%, p = 0.014). In total, 86% of patients who received the patient-centered report felt that it helped them better understand their results and should always be provided. CONCLUSIONS:Patient-centered pathology reports are associated with significantly higher knowledge about a prostate cancer diagnosis. These important health information documents may improve patient-provider communication and help facilitate shared decision-making among patients diagnosed with prostate cancer.
Authors: Nathan Perlis; Antonio Finelli; Mike Lovas; Alexis Lund; Amelia Di Meo; Katherine Lajkosz; Alejandro Berlin; Janet Papadakos; Sangeet Ghai; Dominik Deniffel; Eric Meng; David Wiljer; Shabbir Alibhai; Vasiliki Bakas; Adam Badzynski; Odelia Lee; Joseph Cafazzo; Masoom A Haider Journal: Support Care Cancer Date: 2022-05-10 Impact factor: 3.603